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Old 08-15-2003, 12:16 PM   #1
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Post What should I do now?

Hi all. Sorry if this is a little long. Just hoping for a little advice here. I had my endoscopy two weeks ago. Doctor found a polyp right at the juncture of my stomach and esophagus. He said this confirms the diagnosis of reflux (makes sense to me, but could he possibly be wrong)? Thankfully, the polyp is not cancerous. He also found significant ulceration in my stomach. I tested negative for Helicobacter Pylori. Doctor said all the medicines I have been taking for a another health issue for the past year might have done a number on my stomach. I tried Nexium first, and this did not help me at all in fact made things worse I think. So I stopped it. Then, two days after the endoscopy, something curious happened. For three days I felt very much better. The problem is, I don't know what helped me. At the time, I had started Prevacid, 60 mg a day. I was also on Benadryl and Cogentin for a reaction I had to reglan (only took four doses of reglan total then stopped). I was really excited at the time, thinking the Prevacid had kicked in. Then I ate a taco. Almost immediately my throat became sore and the lump in the throat feeling returned. And now it's been constant for a week. I know now that a taco can upset the stomach but shouldn't it be temporary? I tried taking Carafate liquid, so far it hasn't helped. I think obviously now the Prevacid is not working. So my question is, what next? I want to stop the Prevacid because it seems useless, but do I need it to heal the ulcers in my stomach? Should I try another PPI? Should I try the H2 blockers? Any advice would be appreciated.

 
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Old 08-18-2003, 07:29 AM   #2
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Katie G HB UserKatie G HB User
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Hey there prostator. So sorry for all your troubles. Remember that the PPIs you take are only to REDUCE stomach acid, not other digestive fluids (like pancreatic and liver fluids). You may still be refluxing these acids/bile causing your discomfort. You may need to have a test called esophageal manometry to determine the motility of the esophagus, and the strength/closure of the upper and lower esophageal sphincters. Although I was on PPIs for a few years, I still developed Barrett's esophagus from GERD, and it turns out my lower esophageal sphincter was hypotonic and not staying closed - therefore I was still refluxing.

The only cure that I'm aware of for lower esophageal sphincter weakness is surgery - called Nissan fundoplication. You might need to ask your doc about further testing of the esophagus. The location of the polyp could also be affecting the closure of this sphincter too.

Good luck and keep us posted,
Katie G

 
Old 08-18-2003, 08:27 AM   #3
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Hey Katie G, thanks for the reply. I will definitely ask my doctor about the pressure tests. I'm following up on the polyp, getting done all that needs to be done. I see that you're a senior veteran so I hope you don't mind me asking you some more things. What I really need right now is some kind of symptomatic relief. Do you have any suggestions? I'm having trouble understanding what's really going on here. From what I've read, it seems PPI's, for all the raves, don't work for a lot of people. This is the second one that's doing nothing for me. So, is it that the PPI's are not neutralizing the acid or is it, as you suggested, enzymes or bile or something else is burning my throat? How can I know which is the case? If the latter is the case, what can I take to neutralize those substances? Also, from what I understand, all cases of GERD are due to malfunctioning esophageal sphincters. So why would some people need surgery to correct the sphincter, while some people with GERD do fine on just medication? Hope all is well with you and thanks again.

 
Old 08-18-2003, 10:28 AM   #4
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Hi again prostator. Wow, you ask some very good questions, but I'm not sure I'm expert enough to answer them. I can only tell you what I've researched, lived with, and heard from my surgeon. If GERD remains under good control with PPIs and/or lifestyle changes, then surgery is not typically recommnended. Nissan fundoplication is a last resort in those severe GERD cases or when cell changes, e.g. Barrett's esophagus have occurred, and medication is not helping. In my case, the PPI I was on (Prilosec) did not stop the worsening of my GERD. As far as something that could neutralize the other digestive juices, I have no idea. Even on Prilosec, I was often chewing several antacids tablets daily too, which is NOT recommended by the drug manufacturer. So I'm not real sold on PPIs although I know some people have great success on them. I guess it's an individual thing.

Do some research on PPIs and GERD, as well as alternatives to PPIs just to see what you find. I spent 2 years researching Barrett's and Nissan fundoplication before I actually had the surgery, because the surgery has its drawbacks too, and I wanted to be absolutely sure of my decision. My GERD is under great control since surgery, and I no longer take any PPIs.

Good luck to you,
Katie G

 
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